By Ibrahim S. Bangura
Mental health nurses across Sierra Leone have raised urgent concerns over the growing number of patients suffering from mental health conditions, with over 5,000 recorded cases in Freetown alone. The warning came during the recent World Mental Health Day commemoration held at the New Brookfields Hotel, where professionals, policymakers, NGOs, and advocacy groups gathered to assess progress and challenges in the national mental health sector.
According to the Ministry of Health, Sierra Leone has seen a steady rise in mental health cases, driven by factors such as substance abuse, post-war trauma, depression, stress-related disorders, and the lingering effects of the Ebola and COVID-19 outbreaks. While increased awareness and reporting have contributed to the numbers, experts say the country’s mental health infrastructure remains ill-equipped to meet the growing demand.
Rosaline C. Lahai, a senior mental health nurse at the 34 Military Hospital, described the situation as overwhelming. “We are dealing with more patients than ever, yet the number of trained mental health nurses remains very low. In some health centers, only one professional handles dozens of patients,” she said. Lahai also cited shortages of psychotropic drugs and basic medical supplies, making consistent treatment difficult.
Sierra Leone currently has only one psychiatric hospital—the Sierra Leone Psychiatric Teaching Hospital in Kissy—serving patients nationwide. Many community-based nurses operate under severe resource constraints, with limited logistical support and irregular salaries.
The mental well-being of nurses themselves was a key concern. “We deal with trauma every day, but who takes care of the caregivers?” asked Nurse Daniel Sesay. “Burnout is real, and some of us are silently struggling.”
Sahr Moses from the Chinese Hospital shared his experience working in Western Area 1, where nearly 98% of youth reportedly struggle with substance abuse. Despite limited recognition and resources, Moses continues to provide psychological support, often visiting schools and colleges on foot. “We collaborate with organizations like the Oasis Counseling Centre and sometimes even purchase basic medications ourselves,” he said.
Sia Senesie, a nurse and clinical psychologist at the 34 Military Hospital, reflected on her journey into mental health care during the Ebola outbreak. “The work is risky; I’ve been physically attacked. One of the biggest challenges is medicine supply. Despite these gaps, we continue to provide psychosocial support, sometimes even visiting patients at home,” she said.
Jennifer, a mental health nurse in Freetown, highlighted the stigma surrounding their work. “Some colleagues gave me mocking nicknames when I started. Despite this, we remain passionate and committed,” she said. Her team provides psychological interventions for conditions ranging from anxiety and depression to psychosis and schizophrenia.
Deputy Minister of Health II, Dr. Jalikatu Mustapha, acknowledged the global treatment gap, noting that fewer than 10% of people with mental health conditions receive adequate care. In Sierra Leone, this gap is worsened by a youth drug abuse crisis. She outlined key Ministry achievements, including:
- Establishment of mental health units in every hospital nationwide
- Training of over 500 health workers in basic mental health care
- Launch of a national mental health helpline
- Creation of the Mental Health Champions Network, led by Dr. Jalloh
Dr. Mustapha also announced the nearing completion of the Mental Health Bill, which will replace the outdated Lunacy Act of 1902. The new legislation, expected to pass by the end of 2025, will integrate mental health into the National Health Insurance Scheme and eliminate out-of-pocket payments.
Dr. Mustapha Jalloh, Director of the National Public Health Agency (NPHA), emphasized the importance of mental health during public health emergencies. He noted that one in five people experience mental health challenges during crises and outlined NPHA’s plans to:
- Embed mental health services into routine emergency protocols
- Train responders in psychosocial first aid
- Develop rapid deployment mechanisms for mental health teams
- Engage local leaders and faith groups for culturally sensitive support
- Ensure continuity of care through integrated referral systems
The event concluded with a collective call for increased investment, collaboration, and policy reform to strengthen Sierra Leone’s mental health system and protect the well-being of both patients and caregivers.